目的：比较90μm和110μm飞秒激光制瓣的LASIK矫正近视眼的术后效果。

方法：回顾性分析研究，选取2015-01/2018-12在我院行飞秒准分子激光角膜屈光手术(FS-LASIK)的患者118例236眼。非高度近视组60例120眼，其中30例60眼用90μm角膜瓣，30例60眼为110μm角膜瓣； 高度近视组58例116眼，其中29例58眼为90μm角膜瓣，29例58眼为110μm角膜瓣，使用WaveLight准分子激光仪行基质切削，记录术前矫正远视力(CDVA)、屈光状态和眼压、术后1、3mo裸眼远视力(UDVA)、屈光状态和眼压。

结果：非高度近视患者90μm角膜瓣组和110μm角膜瓣组术后3mo UDVA不差于术前CDVA者均有57眼(95%)，高度近视患者90μm角膜瓣组有53眼(91.4%)和110μm角膜瓣组有56眼(96.6%)(P=0.438)； 非高度近视患者术后等效球镜(SE)在±0.50D范围内90μm角膜瓣组和110μm角膜瓣组均有51眼(85%)，高度近视90μm角膜瓣组和110μm角膜瓣组均有48眼(82.8%)； 非高度近视术后3mo与1mo的SE差值在±0.50D范围内90μm角膜瓣组57眼(95%)和110μm角膜瓣组55眼(91.7%)(P=0.717)，高度近视90μm角膜瓣组44眼(75.9%)和110μm角膜瓣组50眼(86.2%)(P=0.464)。

结论：飞秒激光制作的90μm和110μm角膜瓣的LASIK手术矫正近视眼具有相似良好的有效性、准确性和稳定性，在剩余基质床无差异的前提下，眼压波动没有因为角膜瓣厚度的差异表现出特异性的改变。

METHODS: A total of 236 eyes of 118 myopic patients received LASIK with Wave-Light exeimer laser system. In the non-high myopia group, 30 people(60 eyes)used 90 micron corneal flaps, the other(60 eyes)used 110 micron corneal flaps; in the high myopia group,29 people(58 eyes)used 90 micron corneal flaps,the other(58 eyes)used 110 micron corneal flaps. Uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), manifest refraction and intraocular pressure before operation, at 1mo, 3mo postoperatively were evaluated.

RESULTS: The percent of postoperative UDVA better than or equal to preoperative CDVA after 3mo: 57 eyes(95%). In the non-high myopia group no matter 90 micron corneal flaps or 110 micron corneal flaps. In the high myopia group, there are 53 eyes(91.4%)with 90 micron corneal flaps and 56 eyes(96.6%)with 110 micron corneal flaps(P=0.438); The percent of spherical equivalent refraction(SE)within ±0.50D of the target refraction change: 51 eyes(85%). In the non-high myopia group no matter 90 micron corneal flaps or 110 micron corneal flaps, 48 eyes(82.8%). In the high myopia group with 90 micron corneal flaps or 110 micron corneal flaps; The percent of change in SE within 0.50D between 1mo and 3mo postoperatively: there are 57 eyes(95%)with 90 micron corneal flaps and 55 eyes(91.7%)with 110 micron corneal flapsin the non-high myopia group(P=0.717). In the high myopia group, there are 44 eyes(75.9%)with 90 micron corneal flaps and 50 eyes(86.2%)with 110 micron corneal(P=0.464).

CONCLUSION: Both 90 micron corneal flaps and 110 micron corneal flaps show similar good efficacy, predictability and stability in the correction of myopia.